<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2004-02_10/Fredrick-17.jpg" hspace="4" vspace="4" /> On April 14, 2002, Alvaro Uribe Vélez, then president-elect of Colombia due to take office in one month, travels to Barranquilla. Blanca Linda Rodriguez Charris, age 16, is finishing her after-school job cleaning the small police station next to the bridge that leads to Barranquilla. She is in the sixth grade and is fortunate to be in school at all. She only started classes after taking the job at the police station. It is the policeman who insists she continue her education, and he makes it possible. Her home is a mere ten meters (11 feet) beyond the bridge. A young policeman offers to walk Blanca home. As they prepare to cross the bridge, two small children--a seven-year-old boy and his five-year-old sister--stop with their goat herd to see if he will buy them a Coke. One by one, the animals dart into the police station. Since Blanca has just cleaned it, the officer tells her to wait a moment and hurries back to chase the children and goats from the building. Blanca notices a satchel on the edge of the bridge, but pays little attention. She waits patiently near the satchel as a bus with cars behind it hurries toward her on the road. When the bus passes, a bomb in the satchel detonates. Another, hidden in a fish peddler's cart below the bridge, fortunately malfunctions. The bus driver dies 22 days after the incident. Blanca receives multiple fragmentation wounds and loses her leg above the knee. An infant on the bus is also injured by shrapnel, and the police chief has hearing loss and some mental complications. <h1>Blanca Found Near Death</h1> <table class="clsTableCaption" style="float: right; width: 64.4063%;"> <tbody> <tr> <td style="width: 100%;"><img src="https://opedge.com/Content/OldArticles/images/2004-02_10/Fredrick-16.jpg" alt="Debbie Plescia, CPO, and patient following Blanca's first prosthetic consult." /></td> </tr> <tr> <td style="width: 100%;">Debbie Plescia, CPO, and patient following Blanca's first prosthetic consult.</td> </tr> </tbody> </table> Blanca's mother, Luz Elvia Charris, feels an incredible rumble as the concussion hits her small home. Roof tiles fly off houses near the bridge. Mrs. Charris stumbles outside and sees a car struggle by with all four tires on fire. She doesn't realize it belongs to the president-elect. Down the road, Vélez is hurried out of the mangled vehicle into another that speeds away. Dazed, Mrs. Charris moves toward the bridge. Debris is everywhere. Her neighbor is lying in the door of her house, and Mrs. Charris stops to help. The lady is badly wounded, but sits up, and Mrs. Charris hurries on, seeking her daughter. She crosses the bridge, passing a mangled body. Arriving at the police station, she suddenly realizes the body is wearing her daughter's school dress. She returns to find Blanca near death. I learn all this as Debbie Plescia, CPO, prepares to cast Blanca for an AK prosthesis. In Colombian hospitals, families--not hospital staff--provide food and care. Mrs. Charris stays by Blanca's bed day and night. In her absence, Blanca's younger sister, now 14, is taken advantage of by a boyfriend. She watches Plescia with a big smile as she holds her newborn son. Once Vélez took office, he replaced the Charris' home and others destroyed in the blast. Blanca healed well, but is deeply scarred physically and emotionally. The opportunity to make her first prosthesis is a privilege from a personal perspective, as well as a contribution to Colombia's president. <h1>More Needed than O&P Care</h1> The case is a vivid example of one of the critical differences in rehabilitation between developed and undeveloped nations. Once Blanca is successfully fitted with her prosthesis, we will do our best to insure she continues her education. Such sociological aspects of the patient's personal life are seldom directly targeted by rehabilitation practitioners in the US. Here, they are a necessary ingredient to full recovery. Once we intervene, if we choose to really change the lives of our patients, our responsibility spreads like oil on water. In setting such an example to local practitioners on all levels of the clinical team, the goal is to plant seeds of change beyond Blanca's prosthesis or the new house purchased by the president. My scheduled duties on the trip conclude at an interview with a local representative of ACNUR, the UN Office of the High Commissioner for Refugees. When we attempt to leave the building, the rains have come turning streets into rivers. We are told that during recent similar rains, the houses of 20 poor people were destroyed. Although foot bridges were quickly constructed to allow the poor to pass safely, they must pay to use them. The poor pay for what the rich accept as expected conveniences, at least in this part of the world. What remains for us to determine (hopefully with the aid of a USAID grant), is how to make a few of life's "expected" or humanitarian conveniences available to at least some of Barranquilla's refugees and displaced residents. Nowhere does skill in O&P means as much as it does in an environment like this. It is just the start, the seed of a process that might open the door into a better world--for some, anyway. And, not to be overlooked, it presents an opportunity to give away some of the abundance that we have so carelessly grown accustomed to in the US.
